Orthodontic aligner with isolated segments

ABSTRACT

An orthodontic aligner includes a first plastic segment having a first shape that fits over a first portion of a dental arch of a patient, a second plastic segment having a second shape that fits over a second portion of the dental arch of the patient, and a connector that joins the first plastic segment to the second plastic segment. The connector is configured to be disposed along a lingual side of one or more additional teeth of the patient without exerting a clinically significant force on the one or more additional teeth. The connector spans a gap between the first plastic segment and the second plastic segment, the gap corresponding to the one or more additional teeth that are not to receive the clinically significant force. The connector includes a flexible material that will perform at least one of flex, move or change shape responsive to applied forces.

RELATED APPLICATION

This application is a continuation application of U.S. patentapplication Ser. No. 16/158,140, filed Oct. 11, 2018, which is acontinuation application of U.S. patent application Ser. No. 14/539,725,filed Nov. 12, 2014, now U.S. Pat. No. 10,111,730, issued Oct. 30, 2018,the entire contents of which are incorporated by reference herein.

TECHNICAL FIELD

Embodiments of the present invention relate to the field of orthodonticsand, in particular, to plastic orthodontic aligners.

BACKGROUND

Orthodontic procedures typically involve repositioning a patient's teethto a desired arrangement in order to correct malocclusions and/orimprove aesthetics. To achieve these objectives, orthodontic appliancessuch as braces, retainers, plastic aligners (also referred to as shellaligners), and the like can be applied to the patient's teeth by anorthodontic practitioner. The appliance is configured to exert force onone or more teeth in order to effect desired tooth movements. Theapplication of force can be periodically adjusted by the practitioner(e.g., by altering the appliance or using different types of appliances)in order to incrementally reposition the teeth to a desired arrangement.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is illustrated by way of example, and not by wayof limitation, in the figures of the accompanying drawings.

FIG. 1 illustrates a segmented plastic orthodontic aligner, inaccordance with one embodiment.

FIG. 2 illustrates a segmented plastic orthodontic aligner, inaccordance with another embodiment.

FIG. 3 illustrates a segmented plastic orthodontic aligner, inaccordance with another embodiment.

FIG. 4 illustrates a segmented plastic orthodontic aligner, inaccordance with another embodiment.

FIG. 5 illustrates a plastic orthodontic aligner, in accordance withanother embodiment.

FIG. 6 illustrates a pair of plastic orthodontic aligners designed toapply forces to upper posterior teeth without applying forces to upperanterior teeth, in accordance with another embodiment.

FIG. 7 illustrates a flow diagram of one embodiment for a method oforthodontic treatment using a sequence of aligners.

FIG. 8 illustrates a flow diagram of one embodiment for a method ofmanufacturing a segmented aligner having a connector that isolates forcetransmission between segments.

FIG. 9 illustrates a flow diagram of another embodiment for a method ofmanufacturing a segmented aligner having a connector that isolates forcetransmission between segments.

FIG. 10 illustrates a flow diagram of another embodiment for a method ofmanufacturing a segmented aligner having a connector that isolates forcetransmission between segments.

FIG. 11 illustrates a block diagram of an example computing device, inaccordance with embodiments of the present invention.

DETAILED DESCRIPTION

In some instances, it may be desirable to isolate the forces applied todifferent groups of teeth. Current plastic aligners may not be able toeffectively isolate the forces between different sets of teeth (e.g.,between anterior teeth and posterior teeth). Described herein areembodiments of orthodontic aligners having segments joined by connectorsthat isolate forces between the segments (e.g., that isolate segments sothat no forces or only minimal forces are applied between segments) andmethods of manufacturing and using such orthodontic aligners. Forcetransmission between segments may be reduced compared to forcetransmission between different portions of a non-segmented orthodonticaligner. The segments and connectors can be individually fabricated andprovided as discrete components, or separated from a larger aligner, asdescribed below. The orthodontic aligners described herein, along withrelated systems and methods, can be employed as part of an orthodontictreatment procedure in order to reposition one or more teeth, maintain acurrent position of one or more teeth, or suitable combinations thereof.An orthodontic aligner can include multiple discrete shell segments,each including cavities shaped to receive at least portions of apatient's teeth that are joined by an elastic, rigid or semi-rigidconnector to form a single appliance shell. The geometry, configuration,and material properties of the shell segments and/or connector can beselected to minimize or eliminate the transfer of forces between thesegments. For example, the connector may be designed to prevent aclinically significant force from being applied to one or more teeth bya segment that does not cover those teeth. A clinically significantforce is a force sufficient to change a position or alignment of atooth. This enables separate and distinct forces to be applied to theteeth covered by each of the segments without interference or counterforces from other segments. Additionally, the segmented alignersdisclosed herein may in some instances accommodate larger toothmovements than conventional unsegmented aligners, thus reducing thenumber of different aligners used to complete a course of orthodontictreatment. In some instances, force transmission may be minimized oreliminated in some directions without being affected in otherdirections. For example, distal or mesial forces may be minimizedwithout reducing other forces between segments.

In some instances, a stiffness of the discrete shell segments is greaterthan a stiffness of the connector. This enables isolated force systemsto be created, and enables the treatment of one or more particular teethwithout reaction forces on other teeth. The segmented aligners joined bythe force isolating connectors may improve the treatment of certainmalocclusions in which separate force treatments to separate groups ofteeth are preferred.

Shell segments may vary in design. In some instances, one or more of thediscrete shell segments forming an aligner may be configured to receiveonly a single tooth. In some embodiments, one or more of the discreteshell segments may be configured to span or receive multiple teeth. Analigner may include segments of the same or different types with respectto a number of teeth spanned or received by the segment. For example, anappliance may include some discrete shell segment(s) that span orreceive a single tooth, and some discrete shell segment(s) that span orreceive multiple teeth. Connectors having varied shapes, materialcompositions and design may be used. The same type or a different typeof connector may be used between each pair of adjacent segments.

An aligner as described herein may be included in a series of alignersso as to provide an orthodontic system for positioning teeth. Such anorthodontic system can include a sequence of orthodontic aligners eachincluding a shell having a one or more cavities shaped to receive atleast portions of teeth. The aligners may be successively worn by apatient to move one or more teeth from a first arrangement to a secondarrangement. One or more of the aligners may be segmented and includeconnectors joining segments, as described herein.

Turning now to the drawings, FIG. 1 illustrates an example toothrepositioning appliance or orthodontic aligner 100 that can be worn by apatient in order to achieve an incremental repositioning of individualteeth 102 in the jaw. The orthodontic aligner 100 can include a shell(e.g., a continuous translucent polymeric shell or a segmented shell)having teeth-receiving cavities that receive and resiliently repositionthe teeth 102. The orthodontic aligner 100 or portion(s) thereof may beindirectly fabricated using a physical model or mold of the teeth 102.For example, an aligner can be formed using a physical model of teeth102 and a sheet of suitable layers of polymeric material. In someinstances, an aligner 100 is directly fabricated, e.g., using rapidprototyping fabrication techniques, from a digital model of an aligner.An aligner 100 can fit over all teeth 102 present in an upper or lowerjaw, or less than all of the teeth 102. The aligner 100 can be designedspecifically to accommodate the teeth of the patient (e.g., thetopography of the tooth-receiving cavities matches the topography of thepatient's teeth), and may be fabricated based on positive or negativemodels of the patient's teeth generated by impression, scanning, and thelike. Alternatively, the aligner 100 can be a generic aligner configuredto receive the teeth, but not necessarily shaped to match the topographyof the patient's teeth.

In some cases, only certain teeth received by an aligner will berepositioned by the aligner while other teeth can provide a base oranchor region for holding the appliance in place as it applies forceagainst the tooth or teeth targeted for repositioning. In some cases,many or most, and even all, of the teeth will be repositioned at somepoint during treatment. Teeth that are moved can also serve as a base oranchor for holding the aligner as it is worn by the patient. Typically,no wires or other means will be provided for holding an aligner in placeover the teeth. In some cases, however, it may be desirable to provideindividual attachments or other anchoring elements (not shown) on teeth102 with corresponding receptacles or apertures (not shown) in theorthodontic aligner 100 so that the aligner can apply a selected forceon the tooth.

As shown, the orthodontic aligner 100 includes a first segment 105 and asecond segment 110 separated by a connector 115. In the illustratedexample, the first segment 105, second segment 110 and connector 115 areall portions of a single contiguous plastic body or shell. There may bea gap or space between the first segment 105 and the second segment 110,and the gap may be maintained by the connector 115. However, the portionof the aligner 100 that constitutes the connector 115 may have a lowerrigidity and/or greater flexibility than the first segment 105 and thesecond segment 110. Alternatively, or additionally, the geometry of theconnector 115 may be configured so as to have no or little contact withparticular portions of one or more teeth. For example, the connector 115may not contact the labial side of the anterior teeth (which theconnector 115 may span). The lower rigidity, higher flexibility and/orgeometric configuration is a result of the aligner 100 having been cutto remove a portion of the aligner 100 that would have covered a buccalregion of the anterior teeth of a patient. The decreased rigidity,greater flexibility and/or geometric configuration of the aligner 100 atthe connector 115 serves to isolate, reduce or eliminate forcetransmission between the first segment 105 and the second segment 110.For example, since the aligner has been cut so as not to cover thebuccal region of the anterior teeth, no lingual forces may be applied tothose anterior teeth. This may ensure that no distal forces are appliedto the anterior teeth, even if the posterior teeth covered by the firstsegment 105 and second segment 110 are exposed to forces fordistalization.

As non-limiting examples, illustrated segments 105, 110 each receivemultiple teeth. However, in some instances a segment may be configuredto receive only a single tooth. In additional embodiments, anorthodontic aligner can include segments spanning a single tooth,segments spanning multiple teeth, as well as various combinationsthereof. In aligner construction, segments that span a single tooth, aswell as those that span multiple teeth, are not limited to anyparticular location within the arch, but can have a location selected inappliance design.

The connector 115 can be permanently affixed to the shell segments 105,110 so that the shell segments 105, 110 cannot be nondestructivelydetached from each other. Alternatively, the connector 115 may beremovable from the shell segments 105, 110. In one embodiment, theconnector 115 serves the function of preventing a choking hazard thatmight be caused by the segments when separated.

FIG. 2 illustrates a segmented plastic orthodontic aligner 200, inaccordance with another embodiment. Similar to aligner 100, aligner 200includes a first segment and a second segment 210 joined by a connector215. As with aligner 100, the connector 215 in aligner 200 is formed bycutting away a portion of the body of the aligner 200. However, inaligner 200 a portion of the aligner that would contact the lingual orpalatal region of a patient's anterior teeth is cut out. Thus, thetransfer of buccal forces to the anterior teeth may be avoided. Suchforces may be avoided for the anterior teeth even in instances whereforces are applied to posterior teeth.

FIG. 3 illustrates a segmented plastic orthodontic aligner 300, inaccordance with another embodiment. The aligner 300 includes a firstsegment 305, a second segment 310 and a third segment 315. The firstsegment 305 and third segment 315 are joined by a first connector 320.Similarly, the second segment 310 and third segment 315 are joined by asecond connector 325. The first connector 320 and second connector 325may be an elastomer (e.g., an elastomer adhesive), semi-rigid materialsincluding thermoset and thermoplastic materials, a semi-rigid metalconnector, and so on. In one embodiment, the first connector 320 andsecond connector 325 are an elastomer with a shore hardness of A20 toA80 and an elastic modulus of about 100 pounds per square inch (psi) toabout 100,000 psi. In one embodiment, the first connector 320 and secondconnector 325 are semi-rigid thermoset or thermoplastic materials with ashore hardness from D30 to D80 and an elastic modulus of about 100,000psi to about 350,000 psi. In one embodiment, the first connector 320 andsecond connector 325 are made of metal (e.g., metal wire, metal ribbon,etc.). In one embodiment, the connectors 320, 325 are formed from anelastic adhesive (e.g., an elastomer adhesive) that effectively bondsthe segments with an elastic bond. In another embodiment, the connectors320, 325 are formed from a polyurethane elastomer (PTE). In anotherembodiment, connectors 320, 325 are formed from plastics, metals (e.g.,arch wires), and/or other materials. The connectors 320, 325 may beelastic, totally rigid, connected with a pivot, and/or connected with ageometry that transmits certain directional forces without transmittingother forces.

Connectors 320, 325 may be formed from a single material or frommultiple materials. The materials may be arranged in one or more layers.For example, layers of different materials or layers of the samematerial may be used to form the connectors 320, 325. Properties of thematerial used to form the connectors 320, 325 such as resiliency,elasticity, hardness/softness, color, and the like can be determined, atleast partially, based on the selected material, material shape,material dimensions, layers of material, and/or material thickness. Inone embodiment, the connectors 320, 325 are formed from elasticmaterials such as an elastomer material.

In some instances, the connectors 320, 325 can be configured such thatone or more properties are uniform along a length or portion ofconnectors. Additionally, one or more properties of the connectors mayvary along a length or portion of the connectors. For example, aconnector 320, 325 may have substantially uniform thickness along alength or portion, or may vary along a length or portion. As will beappreciated, characteristics of the connector may be selected so as toreduce or eliminate force transfer between different segments of thealigner and/or groups of teeth.

In the illustrated example aligner 300, the connectors 320, 325 operateto reduce or eliminate force transmission between left and rightposterior teeth and anterior teeth of a patient. This enables theposterior teeth to be distalized as a unit, while separate movement canbe applied to the anterior teeth (e.g., to the patient's incisors).Alternatively, a mesial force may be applied to the posterior teethwithout exerting a mesial force on the anterior teeth. The treatments ofthe posterior teeth would not affect or interfere with the treatments ofthe posterior teeth. Likewise, the treatments of the posterior teethwould not affect or interfere with the treatments of the anterior teeth.

FIG. 4 illustrates a segmented plastic orthodontic aligner 400, inaccordance with another embodiment. The aligner 400 includes a firstsegment 405 joined to a second segment 410 by a bridge-like connector415. The connector 415 is a semi-rigid material that flexes rather thantransferring forces between the first and second segments 405, 410. Theconnector 415 may be a pre-formed connector, which may be glued ormechanically attached to the segments.

In one embodiment, the segments 405, 410 each include a retentionfeature that is sized and shaped to retain an end of the connector 415.For example, the connector 415 may snap into place in the features.These features may be designed into the aligner 400. For example, thesefeatures may be included in mold that is used to form the aligner sothat the aligner includes the features. Alternatively, these featuresmay be formed in (e.g., cut into) the segments and/or attached to thesegments after the segments are formed. Some examples of retentionfeatures include grooves, ridges, protrusions, indentations, male orfemale portions of mechanical snaps or locks, etc. The retentionfeatures can be used to prevent the accidental displacement or releaseof the connector 415 from a desired position, thereby ensuring that thealigner 400 does not separate or pose a choking hazard.

FIG. 5 illustrates a plastic orthodontic aligner 500, in accordance withanother embodiment. The aligner 500 includes a first segment 505 joinedto a first side of a third segment 515 by a first connector 520. Thealigner 500 additionally includes a second segment 510 joined to asecond side of the third segment 515 by a second connector 525. Thefirst and second connectors 520, 525 are corrugated connectors with anaccordion-like shape. The corrugated configuration will flex beforeapplying clinically significant forces between segments. Thus, thecorrugation between segments reduces force transmitted between segmentsduring treatment. In one embodiment, the corrugated connectors 520, 525are formed of the same material as the segments 505-515 (e.g., anelastomer). In one embodiment, as shown, the connectors 520, 525 and thesegments 505-515 form a single contiguous shell body. Alternatively, theconnectors 520, 525 may be separate components that are attached to thesegments 505-515. In such an instance, the connectors 520-525 may be thesame material as the segments or a different material. For example, theconnectors 520-525 may be formed of an elastomer.

FIG. 6 illustrates a pair of plastic orthodontic aligners designed toapply forces to upper posterior teeth without applying forces to upperanterior teeth, in accordance with another embodiment. The pair ofaligners includes an upper aligner 608 and a lower aligner 605. Thelower aligner 605 is a conventional unsegmented aligner that includes aretention feature 630. As shown, the retention feature 630 may belocated at a molar or other posterior tooth. The retention feature maybe a slit, cut, groove, protrusion, or other feature that may secure oneend of an elastic band 635 (e.g., such as a rubber band). Alternatively,the lower aligner 605 may include a discontinuity such as a cut, flap,aperture (e.g., opening, window, gap, notch, etc.) rather than aretention feature. A retention feature may accordingly be bondeddirectly to a patient's tooth at the location of the discontinuity. Thediscontinuity may expose the retention feature when the lower aligner605 is worn by the patient.

The upper aligner 605 is a segmented aligner including a first segment610 and a second segment 615 joined by a connector 620. The firstsegment 610 includes a retention feature 625 that is to secure a secondend of the elastic band 635. As shown, the retention feature 625 may belocated at a canine or other anterior tooth. Alternatively, the firstsegment 610 may include a discontinuity such as a cut, flap, aperture(e.g., opening, window, gap, notch, etc.) rather than a retentionfeature. A retention feature may accordingly be bonded directly to apatient's tooth at the location of the discontinuity. The discontinuitymay expose the retention feature when the upper aligner 608 is worn bythe patient.

The elastic band 635 may apply a distal force to the first segment, andthus to a group of teeth covered by the first segment 610. A similarelastic band may extend between additional retention features on thesecond segment 615 and the lower aligner 605, and may apply a distalforce to the second segment and thus to a group of teeth covered by thesecond segment 615. The connector 620 may isolate forces so that noforces are applied to any upper anterior teeth of the patient. In analternative embodiment, the retention feature 625 may be located on anupper posterior tooth, and the retention feature 630 may be located on alower anterior tooth. In such a configuration a mesial force may beapplied to the second segment 615 without being applied to the firstsegment 610.

In an alternative example, the upper and/or lower aligner may be any ofthe segmented aligners described herein. For example, the upper alignermay be similar to aligner 300 of FIG. 3, and may include three segmentsjoined by two connectors rather than two segments joined by a singleconnector.

The appliances described herein can be used in combination with one ormore attachments mounted onto one or more of the received teeth.Accordingly, the topography of the shell segment can be modified toaccommodate the attachment (e.g., with a suitable receptacle forreceiving the attachment). The attachment can engage the shell segmentsand/or elastics to transmit repositioning forces to the underlyingteeth, as previously described herein. Alternatively or in addition, theattachment can be used to retain the appliance on the patient's teethand prevent it from inadvertently becoming dislodged. For example, teethwith no undercuts (e.g., central teeth, lateral teeth) may require anattachment to ensure correct engagement of the attachment onto theteeth, while teeth with natural undercuts (e.g., molars) may not requirean attachment. The attachment can be mounted onto any suitable portionof the tooth, such as on a buccal or lingual surface of the tooth.

FIG. 7 illustrates a flow diagram of one embodiment for a method 700 oforthodontic treatment using a sequence of aligners. The method 700 canbe practiced using any of the aligners or aligner sets described herein.In block 710, a first orthodontic aligner is applied to a patient'steeth in order to reposition the teeth from a first tooth arrangementtoward a second tooth arrangement. The patient's teeth are arranged suchthat different forces are to be applied to teeth by different segments.These forces may have been incompatible using traditional aligners,because reactive forces from some segments may have acted to undermineforces to be applied to teeth by other segments.

At block 720, a second orthodontic aligner is applied to the patient'steeth in order to reposition the teeth from the second tooth arrangementto a third tooth arrangement. The repositioning of the teeth from thesecond arrangement to the third arrangement may be accomplished usingtraditional aligners (e.g., unsegmented aligners). Accordingly, atraditional unsegmented aligner may be used to reposition the teeth fromthe second arrangement to the third arrangement. Alternatively, thesecond orthodontic aligner may be another segmented aligner thatisolates forces between different segments. The second orthodonticaligner may be segmented in the same manner as the first orthodonticaligner or in a different manner from the first orthodontic aligner. Forexample, the first orthodontic aligner may include two segmentsseparated by a single connector, and the second orthodontic aligner mayinclude three segments, each joined by a different connector. Thedifferent aligners may be segmented, for example, to apply forces todifferent groups of teeth.

The method 700 can be repeated using any suitable number and combinationof sequential aligners in order to incrementally reposition thepatient's teeth from an initial arrangement to a target arrangement. Thealigners can be generated all at the same stage or in sets or batches(e.g., at the beginning of a stage of the treatment), and the patientcan wear each aligner until the pressure of each aligner on the teethcan no longer be felt or until the maximum amount of expressed toothmovement for that given stage has been achieved. Multiple differentaligners (e.g., a set) can be designed and even fabricated prior to thepatient wearing any aligner. After wearing an aligner for an appropriateperiod of time, the patient can replace the current aligner with thenext aligner in the series until no more aligners remain. The alignersare generally not affixed to the teeth and the patient may place andreplace the aligners at any time during the procedure (e.g.,patient-removable aligners).

The final aligner or several aligners in the series may have a geometryor geometries selected to overcorrect the tooth arrangement. Forinstance, one or more aligners may have a geometry that would (if fullyachieved) move individual teeth beyond the tooth arrangement that hasbeen selected as the “final.” Such over-correction may be desirable inorder to offset potential relapse after the repositioning method hasbeen terminated (e.g., permit movement of individual teeth back towardtheir pre-corrected positions). Over-correction may also be beneficialto speed the rate of correction (e.g., an aligner with a geometry thatis positioned beyond a desired intermediate or final position may shiftthe individual teeth toward the position at a greater rate). In suchcases, the use of an aligner can be terminated before the teeth reachthe positions defined by the aligner. Furthermore, over-correction maybe deliberately applied in order to compensate for any inaccuracies orlimitations of the aligner.

FIG. 8 illustrates a flow diagram of one embodiment for a method 800 ofmanufacturing a segmented aligner having a connector that isolates,reduces or eliminates force transmission between segments. In someembodiments, one or more operations of method 800 are performed byprocessing logic of a computing device. The processing logic may includehardware (e.g., circuitry, dedicated logic, programmable logic,microcode, etc.), software (e.g., instructions executed by a processingdevice), firmware, or a combination thereof. For example, one or moreoperations of method 800 may be performed by a computing device such ascomputing device 1101 of FIG. 11. Additionally, some operations may beperformed by a fabrication machine based on instructions received fromprocessing logic. Some operations may alternately be performed by auser.

At block 805 of method 800, a shape is determined for a mold of a dentalarch for a patient. The shape may be determined by digitally planning anintermediate or final target arrangement of the patient's teeth, andfabricating a mold of a dental arch that reflects that intermediate orfinal target arrangement. Alternatively, the shape may be determined bytaking an impression of a patient's arch and generating a mold from theimpression. Thus, the mold or model can be generated from dentalimpressions or scanning (e.g., of the patient's intraoral cavity, of apositive or negative model of the patient's intraoral cavity, or of adental impression formed from the patient's intraoral cavity).

Aligner fabrication or design can make use of one or more physical ordigital representations of the patient's teeth. Representations of thepatient's teeth can include representations of the patient's teeth in acurrent arrangement, and may further include representations of thepatient's teeth repositioned in one or more treatment stages. Treatmentstages can include a desired or target arrangement of the patient'steeth, such as a desired final arrangement of teeth. Treatment stagescan also include one or more intermediate arrangements of teeth (e.g.,planned intermediate arrangements) representing arrangements of thepatient's teeth as the teeth progress from a first arrangement (e.g.,initial arrangement) toward a second or desired arrangement (e.g.,desired final arrangement).

In one embodiment, at block 808 a digital representation of a patient'steeth is received. The digital representation can include surfacetopography data for the patient's intraoral cavity (including teeth,gingival tissues, etc.). The surface topography data can be generated bydirectly scanning the intraoral cavity, a physical model (positive ornegative) of the intraoral cavity, or an impression of the intraoralcavity, using a suitable scanning device (e.g., a handheld scanner,desktop scanner, etc.).

In one embodiment, at block 809 one or more treatment stages aregenerated based on the digital representation of the teeth. Thetreatment stages can be incremental repositioning stages of anorthodontic treatment procedure designed to move one or more of thepatient's teeth from an initial tooth arrangement to a targetarrangement. For example, the treatment stages can be generated bydetermining the initial tooth arrangement indicated by the digitalrepresentation, determining a target tooth arrangement, and determiningmovement paths of one or more teeth in the initial arrangement necessaryto achieve the target tooth arrangement. The movement path can beoptimized based on minimizing the total distance moved, preventingcollisions between teeth, avoiding tooth movements that are moredifficult to achieve, or any other suitable criteria.

At block 810, the mold is fabricated based on the determined shape. Thismay include using a three-dimensional virtual model of the dental archand sending instructions to a rapid prototyping machine (e.g., athree-dimensional printer) to fabricate the mold. In one embodiment, thebreakable mold is fabricated using a rapid prototyping manufacturingtechnique. One example of a rapid prototyping manufacturing technique is3D printing. 3D printing includes any layer-based additive manufacturingprocesses. A 3D printer may receive an input of the 3D virtual model ofthe mold (e.g., as a computer aided drafting (CAD) file or 3D printablethe such as a stereolithography (STL) file), and may use the 3D virtualmodel to create the mold. 3D printing may be achieved using an additiveprocess, where successive layers of material are formed in proscribedshapes. 3D printing may be performed using extrusion deposition,granular materials binding, lamination, photopolymerization, or othertechniques.

In one embodiment, stereolithography (SLA), also known as opticalfabrication solid imaging, is used to fabricate an SLA mold. In SLA, themold is fabricated by successively printing thin layers of aphoto-curable material (e.g., a polymeric resin) on top of one another.A platform rests in a bath of a liquid photopolymer or resin just belowa surface of the bath. A light source (e.g., an ultraviolet laser)traces a pattern over the platform, curing the photopolymer where thelight source is directed, to form a first layer of the mold. Theplatform is lowered incrementally, and the light source traces a newpattern over the platform to form another layer of the mold at eachincrement. This process repeats until the mold is completely fabricated.Each layer may have a thickness of between 25 microns and 200 microns.Once all of the layers of the mold are formed, the mold may be cleanedand cured.

At block 815, a plastic orthodontic aligner is formed over the mold.This may include sending instructions to a pressure forming orthermoforming machine to cause a sheet of material to be pressure formedor thermoformed over the mold to form a body of the aligner. The sheetmay be, for example, a sheet of plastic (e.g., an elasticthermoplastic). To thermoform the shell or aligner over the mold, thesheet of material may be heated to a temperature at which the sheetbecomes pliable. Pressure may concurrently be applied to the sheet toform the now pliable sheet around the breakable mold. Once the sheetcools, it will have a shape that conforms to the mold. In oneembodiment, a release agent (e.g., a non-stick material) is applied tothe mold before forming the aligner. This may facilitate later removalof the mold from the aligner. The plastic orthodontic aligner mayinclude a first segment and a second segment that are formed together(e.g., that are formed simultaneously). In some embodiments, a connectormay also be formed together with the formation of the first and secondsegments.

Other exemplary methods for fabricating aligners or discrete segmentsand/or connectors of aligners include rapid prototyping,stereolithography, or computer numerical control (CNC) milling. Thematerial of the aligner or shell segments can be translucent, such as atranslucent polymer.

At block 820, the plastic orthodontic aligner is cut to divide thealigner into at least two segments separated by connectors. This mayinclude sending instructions to a cutting machine to cause the cuttingmachine to cut the aligner at specified coordinates. The cutting machinemay be, for example, a laser cutter, plasma cutter or mill. The at leasttwo segments and the connectors are portions of a single contiguousplastic body. The discrete shell segments each include one or morecavities shaped to receive at least portions of teeth. The shellsegments can collectively receive a continuous span of teeth. The numberand shape of the shell segments can be selected to accommodate thedesired tooth movements, and the connectors can isolate forces to permitdifferent tooth movements to different sets of teeth. The aligner mayalso be marked and/or trimmed along a gingival cut line.

A set of aligners can be fabricated, each shaped to accommodate a tootharrangement specified by one of the treatment stages, such that thealigners can be sequentially worn by the patient to incrementallyreposition the teeth from the initial arrangement to the targetarrangement. The aligner set may include one or more of the segmentedaligners described herein. The properties of the shell segments andconnectors of such segmented aligners (e.g., number, geometry,configuration, material characteristics) can be selected to elicit thetooth movements specified by the corresponding treatment stage. At leastsome of these properties can be determined via suitable computersoftware or other digital-based approaches. The fabrication of thealigner may involve creating a digital model of the aligner to be usedas input to a computer-controlled fabrication system.

FIG. 9 illustrates a flow diagram of another embodiment for a method 900of manufacturing a segmented aligner having a connector that isolatesforce transmission between segments. In some embodiments, one or moreoperations of method 900 are performed by processing logic of acomputing device. The processing logic may include hardware (e.g.,circuitry, dedicated logic, programmable logic, microcode, etc.),software (e.g., instructions executed by a processing device), firmware,or a combination thereof. For example, one or more operations of method900 may be performed by computing device such as computing device 1101of FIG. 11. Additionally, some operations may be performed by afabrication machine based on instructions received from processinglogic. Some operations may alternately be performed by a user (e.g.,based on user interaction with a mold modeling module or draftingprogram).

At block 905 of method 900, a shape is determined for a mold of a dentalarch for a patient. The shape may be determined by digitally planning anintermediate or final target arrangement of the patient's teeth, andfabricating a mold of a dental arch that reflects that intermediate orfinal target arrangement. Alternatively, the shape may be determined bytaking an impression of a patient's arch and generating a mold from theimpression. At block 910, the mold is fabricated based on the determinedshape (e.g., based on sending instructions to a rapid prototypingmachine). This may include using a three-dimensional virtual model ofthe dental arch and a rapid prototyping machine (e.g., athree-dimensional printer) to fabricate the mold.

At block 915, a plastic orthodontic aligner is formed over the mold(e.g., based on sending instructions to a thermoforming or pressureforming machine). In one embodiment, the plastic orthodontic aligner isthermoformed or pressure formed over the mold. Other exemplary methodsfor fabricating aligners or discrete segments and/or connectors ofaligners include rapid prototyping, stereolithography, or computernumerical control (CNC) milling. The material of the aligner or shellsegments can be translucent, such as a translucent polymer.Alternatively, the material may have any other desired color or colors.

At block 920, the plastic orthodontic aligner is cut to divide thealigner into at least two segments separated by connectors (e.g., basedon sending instructions to a cutting machine). The aligner may be cutusing a laser cutter, a plasma cutter, a mill, or a mechanical cutter.The aligner is cut to separate the aligner into multiple discreetsegments that are not joined.

At block 925, the discrete shell segments are joined using a connector(or multiple connectors), thereby forming a single aligner shell. In oneembodiment, instructions are sent to a machine to cause the machine tojoin the segments to the connector. Alternatively, a prompt may beoutput to a display to instruct a user to manually connect the segmentsto the connector. The connector may be an elastic material.Alternatively, the connector may be a plastic such as a semi-rigidplastic. Other elastic or semi-rigid materials may also be used. In manyembodiments, the connector is translucent. The connector can be providedas strips, bands, sheets, meshes, coatings, layers, tubes, elasticglues, or suitable combinations thereof, and can be fabricated from anysuitable material. Example fabrication methods for elastics includeextrusion, rapid prototyping, spraying, thermoforming, or suitablecombinations thereof. The characteristics of the connector (e.g.,length, width, thickness, area, shape, cross-section, stiffness, etc.)may be homogeneous throughout the bulk of the elastic material, or maybe variable. For example, different portions of connector may havedifferent thicknesses, thereby altering the local compliance of thealigner. Furthermore, in some instances, the connector can haveanisotropic characteristics. As an example, the connector may berelatively compliant along a first direction, and less compliant (ornoncompliant) along a second direction. The directionality of theconnector's flexibility can be used to mitigate the transfer of forcesbetween teeth while still providing structure and stability to thealigner. The connector can be coupled to the segments using suitableadhesives or bonding agents. In some instances, the connector may haveadhesive properties, thus enabling the connector to be directly coupledto the shell segments without the use of additional external agents.Example methods of attaching the connector to the shell segments includeextrusion, spraying, coating, dipping, or suitable combinations thereof.The connector may also be physically connected to the segments usingsnaps, clasps, locks, etc. For example, the connector may include a maleend of a snap and a retention feature in a segment may include a femaleend of the snap. In one embodiment, additional information may be sentto one or more machines to cause the machines to form a retentionfeature in a segment. The retention feature may be to retain an elasticband that may later be attached to the retention feature and to anotherretention feature on another aligner, segment of aligner or tooth. Inone embodiment, forming the retention feature includes cutting a slit orgroove in a segment of the aligner.

FIG. 10 illustrates a flow diagram of another embodiment for a method ofmanufacturing a segmented aligner having a connector that isolates,reduces or eliminates force transmission between segments. In someembodiments, one or more operations of method 1000 are performed byprocessing logic of a computing device. The processing logic may includehardware (e.g., circuitry, dedicated logic, programmable logic,microcode, etc.), software (e.g., instructions executed by a processingdevice), firmware, or a combination thereof. For example, one or moreoperations of method 1000 may be performed by computing device such ascomputing device 1101 of FIG. 11. Additionally, some operations may beperformed by a fabrication machine based on instructions received fromprocessing logic. Some operations may alternately be performed by a user(e.g., based on user interaction with a mold modeling module or draftingprogram).

At block 1005 of method 1000, a shape is determined for a first mold ofa first dental arch and for a second mold of a second portion of thedental arch. The first mold may represent a first set of teeth of apatient and the second mold may represent a second set of teeth of thepatient. The shapes may be determined by digitally planning anintermediate or final target arrangement of the patient's teeth.Alternatively, the shapes may be determined by taking impressions of apatient's arch. At block 1010, the molds are fabricated based on thedetermined shapes. This may include using a three-dimensional virtualmodel of the dental arch and a rapid prototyping machine (e.g., athree-dimensional printer) to fabricate the molds.

At block 1015, a first segment of a plastic orthodontic aligner isformed over the first mold. In one embodiment, the first segment of theplastic orthodontic aligner is thermoformed or pressure formed over themold. At block 1020, a second segment of the plastic orthodontic aligneris formed over the second mold. Exemplary methods for fabricating thesegments include thermoforming, rapid prototyping, stereolithography, orcomputer numerical control (CNC) milling.

At block 1025, the discrete shell segments are joined using a connector(or multiple connectors), thereby forming a single aligner shell. Theconnector may be an elastic material. Alternatively, the connector maybe a plastic such as a semi-rigid plastic. Other elastic or semi-rigidmaterials may also be used.

FIG. 11 is a simplified block diagram of a system 1100 that may be usedin executing methods and processes described herein. The system 1100typically includes a computing device 1101 connected to a network 1124,a scanner 1120 and/or a fabrication machine 1122. The computing device1101 may be connected (e.g., networked) to other machines in a LocalArea Network (LAN), an intranet, an extranet, or the Internet. Forexample, the computing device 1101 may be networked fabrication machine1122, which may be a rapid prototyping apparatus such as a 3D printer orSLA apparatus. The computing device 1101 may operate in the capacity ofa server or a client machine in a client-server network environment, oras a peer machine in a peer-to-peer (or distributed) networkenvironment. The computing device 1101 may be a personal computer (PC),a tablet computer, a set-top box (STB), a Personal Digital Assistant(PDA), a cellular telephone, a web appliance, a server, a networkrouter, switch or bridge, or any machine capable of executing a set ofinstructions (sequential or otherwise) that specify actions to be takenby that machine. Further, while only a single machine is illustrated,the term computing device shall also be taken to include any collectionof machines (e.g., computers) that individually or jointly execute a set(or multiple sets) of instructions to perform any one or more of themethodologies discussed herein.

Computing device 1101 includes at least one processing device 1102 thatcommunicates with one or more peripheral devices via bus subsystem 1104.Processing device 1102 represents one or more general-purpose processorssuch as a microprocessor, central processing unit, or the like. Moreparticularly, the processing device 1102 may be a complex instructionset computing (CISC) microprocessor, reduced instruction set computing(RISC) microprocessor, very long instruction word (VLIW) microprocessor,processor implementing other instruction sets, or processorsimplementing a combination of instruction sets. Processing device 1102may also be one or more special-purpose processing devices such as anapplication specific integrated circuit (ASIC), a field programmablegate array (FPGA), a digital signal processor (DSP), network processor,or the like. Processing device 1102 is configured to execute theprocessing logic (instructions) for performing operations and stepsdiscussed herein.

Peripheral devices typically connected to processing device 1102 includea storage subsystem 1106 (memory subsystem 1108 and file storagesubsystem 1114), a set of user interface input and output devices 1118,and an interface to outside networks 1116. This interface is shownschematically as “Network Interface” block 1116, and is coupled tocorresponding interface devices in other data processing systems viacommunication network interface 1124.

The user interface input devices 1118 are not limited to any particulardevice, and can typically include, for example, a keyboard, pointingdevice, mouse, scanner, interactive displays, touchpad, joysticks, etc.Similarly, various user interface output devices can be employed in asystem of the invention, and can include, for example, one or more of aprinter, display (e.g., visual, non-visual) system/subsystem,controller, projection device, audio output, and the like.

Storage subsystem 1106 maintains basic programming of the computingdevice 1101, including computer readable media having instructions(e.g., operating instructions, etc.), and data constructs. The programmodules discussed herein are typically stored in storage subsystem 1106.Storage subsystem 1106 typically includes memory subsystem 1108 and filestorage subsystem 1114. Memory subsystem 1108 typically includes anumber of memories (e.g., RAM 1110, ROM 1112, etc.) including computerreadable memory for storage of fixed instructions, instructions and dataduring program execution, basic input/output system, etc. File storagesubsystem 1114 provides persistent (non-volatile) storage for programand data files, and can include one or more removable or fixed drives ormedia, hard disk, floppy disk, CD-ROM, DVD, optical drives, and thelike.

The file storage subsystem 1114 may include a machine-readable storagemedium (or more specifically a non-transitory computer-readable storagemedium) on which is stored one or more sets of instructions embodyingany one or more of the methodologies or functions described herein. Anon-transitory storage medium refers to a storage medium other than acarrier wave. The instructions may also reside, completely or at leastpartially, within the memory subsystem 1108 and/or within the processingdevice 1102 during execution thereof by the computer device 1101, thememory subsystem 1108 and the processing device 1102 also constitutingcomputer-readable storage media.

The computer-readable storage medium may also be used to store one ormore virtual 3D models and/or a segmented aligner generation module1150, which may perform one or more of the operations of methods800-1000 described with reference to FIGS. 8-10. The term“computer-readable storage medium” should be taken to include a singlemedium or multiple media (e.g., a centralized or distributed database,and/or associated caches and servers) that store the one or more sets ofinstructions. The term “computer-readable storage medium” shall also betaken to include any medium other than a carrier wave that is capable ofstoring or encoding a set of instructions for execution by the machineand that cause the machine to perform any one or more of themethodologies of the present invention. The term “computer-readablestorage medium” shall accordingly be taken to include, but not belimited to, solid-state memories, and optical and magnetic media.

One or more of the storage systems, drives, etc. may be located at aremote location, such coupled via a server on a network or via theinternet/World Wide Web. In this context, the term “bus subsystem” isused generically so as to include any mechanism for letting the variouscomponents and subsystems communicate with each other as intended andcan include a variety of suitable components/systems that would be knownor recognized as suitable for use therein. It will be recognized thatvarious components of the system can be, but need not necessarily be atthe same physical location, but could be connected via variouslocal-area or wide-area network media, transmission systems, etc.

Scanner 1120 includes any means for obtaining a digital representation(e.g., images, surface topography data, etc.) of a patient's teeth(e.g., by scanning physical models of the teeth such as casts, byscanning impressions taken of the teeth, or by directly scanning theintraoral cavity of a patient). Scanner 1120 may receive or generatedental arch data 1121 (which may be data usable to generate a 3D virtualmodel of a patient's dental arch), and may provide such dental arch data1121 to computing device 1101. Scanner 1120 may be located at a locationremote with respect to other components of the system and cancommunicate image data and/or information to computing device 1101, forexample, via network interface 1124. Fabrication system 1122 fabricatesorthodontic aligners 1123 based on a treatment plan, including data setinformation received from computing device 1101. Fabrication machine1122 can, for example, be located at a remote location and receive dataset information from computing device 1101 via network interface 1124.

It is to be understood that the above description is intended to beillustrative, and not restrictive. Many other embodiments will beapparent upon reading and understanding the above description. Althoughembodiments of the present invention have been described with referenceto specific example embodiments, it will be recognized that theinvention is not limited to the embodiments described, but can bepracticed with modification and alteration within the spirit and scopeof the appended claims. Accordingly, the specification and drawings areto be regarded in an illustrative sense rather than a restrictive sense.The scope of the invention should, therefore, be determined withreference to the appended claims, along with the full scope ofequivalents to which such claims are entitled.

What is claimed is:
 1. An orthodontic aligner comprising: a firstplastic segment having a first shape that fits over a first portion of adental arch of a patient, wherein the first plastic segment isconfigured to apply a force to a first set of teeth in the first portionof the dental arch; a second plastic segment having a second shape thatfits over a second portion of the dental arch of the patient; and aconnector that joins the first plastic segment to the second plasticsegment, wherein the connector is configured to be disposed along alingual side of one or more additional teeth of the patient withoutexerting a clinically significant force on the one or more additionalteeth, wherein the connector spans a gap between the first plasticsegment and the second plastic segment, the gap corresponding to the oneor more additional teeth that are not to receive the clinicallysignificant force, and wherein the connector comprises a flexiblematerial that will perform at least one of flex, move or change shaperesponsive to applied forces.
 2. The orthodontic aligner of claim 1,wherein the first plastic segment, the second plastic segment, and theconnector are portions of a single contiguous plastic body.
 3. Theorthodontic aligner of claim 1, wherein the connector is removablyattachable to the first plastic segment and the second plastic segment.4. The orthodontic aligner of claim 1, wherein the first set of teethcomprise one or more posterior teeth and the one or more additionalteeth comprise one or more anterior teeth.
 5. The orthodontic aligner ofclaim 1 further comprising: a third plastic segment having a third shapethat fits over a third portion of the dental arch of the patient; and asecond connector that joins the third plastic segment with the firstplastic segment or the second plastic segment.
 6. The orthodonticaligner of claim 1, wherein the connector comprises at least one of anelastomer, a semi-rigid thermoset, or a semi-rigid thermoplastic.
 7. Theorthodontic aligner of claim 1, wherein the connector is adhered ormechanically attached to the first plastic segment and the secondplastic segment.
 8. The orthodontic aligner of claim 1, wherein thefirst plastic segment forms a first retention feature that is sized andshaped to retain a first end of the connector, and wherein the secondplastic segment forms a second retention feature that is sized andshaped to retain a second end of the connector.
 9. The orthodonticaligner of claim 1, wherein the connector comprises a corrugatedconfiguration that is to flex without exerting the clinicallysignificant force on the one or more additional teeth.
 10. Theorthodontic aligner of claim 1, further comprising a retention featureon the first plastic segment, wherein the retention feature isconfigured to receive an elastic band, and wherein the elastic band isto apply a distal force or a mesial force to the first set of teethwithout applying force to a second set of teeth in the second portion ofthe dental arch.
 11. The orthodontic aligner of claim 1, wherein theconnector is configured to isolate the force applied to the first set ofteeth from separate and distinct forces applied to a second set of teethin the second portion of the dental arch.
 12. An orthodontic alignercomprising: a first plastic segment having a first shape that fits overa first portion of a dental arch of a patient, wherein the first plasticsegment is configured to apply a first force to a first set of teeth inthe first portion of the dental arch; a second plastic segment having asecond shape that fits over a second portion of the dental arch of thepatient, wherein the second plastic segment is configured to apply asecond force to a second set of teeth in the second portion of thedental arch; and a connector disposed between the first plastic segmentand the second plastic segment along a third set of teeth in a thirdportion of the dental arch without exerting a clinically significantforce on the third set of teeth, wherein the connector spans a gapbetween the first plastic segment and the second plastic segment, thegap corresponding to the third set of teeth that are not to receive theclinically significant force, and wherein the connector comprises aflexible material that will perform at least one of flex, move or changeshape responsive to applied forces.
 13. The orthodontic aligner of claim12, wherein the first plastic segment, the second plastic segment, andthe connector are portions of a single contiguous plastic body.
 14. Theorthodontic aligner of claim 12, wherein the connector is removablyattachable to the first plastic segment and the second plastic segment.15. The orthodontic aligner of claim 12, wherein the first set of teethcomprise one or more posterior teeth and the third set of teeth compriseone or more anterior teeth.
 16. The orthodontic aligner of claim 12further comprising: a third plastic segment having a third shape thatfits over a fourth portion of the dental arch of the patient; and asecond connector disposed between the third plastic segment and one ofthe first plastic segment or the second plastic segment.
 17. Theorthodontic aligner of claim 12, wherein the connector comprises atleast one of an elastomer, a semi-rigid thermoset, or a semi-rigidthermoplastic.
 18. The orthodontic aligner of claim 12, wherein theconnector is adhered or mechanically attached to the first plasticsegment and the second plastic segment.
 19. The orthodontic aligner ofclaim 12, wherein the first plastic segment forms a first retentionfeature that is sized and shaped to retain a first end of the connector,and wherein the second plastic segment forms a second retention featurethat is sized and shaped to retain a second end of the connector. 20.The orthodontic aligner of claim 12, wherein the connector is configuredto isolate the first force applied to the first set of teeth from thesecond force applied to the second set of teeth.